Criteria For Obsessive-compulsive Personality Disorder Research Articles

Subjective fatigue in individuals with anxiety and mood disorders correlates with specific traits of obsessive-compulsive personality disorder

Fatigue is a common debilitating symptom in individuals with anxiety and mood disorders, also known as common mental disorders (CMD). Aspects of fatigue are seen to be independently associated with the presence of obsessive-compulsive personality disorder (OCPD) in individuals with CMD. However, the relationship between different traits of OCPD and fatigue is still under-researched. Therefore, the aim of our study was to examine the associations between individual OCPD traits and fatigue in those with CMD. This cross-sectional study investigated 203 individuals (76.8% female, mean age 40.8 ± 11.8) attending a stress-related disorders day care unit. Participants were evaluated for OCPD traits by using the Compulsive Personality Assessment Scale and completed the Multidimensional Fatigue Inventory-20. Out of 203 participants, 42 (20.7%) fulfilled operational criteria for OCPD (73.8% female). Participants with OCPD had greater reduced motivation, mental and physical fatigue scores than those without OCPD (13.2 ± 3.6 vs. 14.5 ± 3.6, p = 0.035; 14.4 ± 4.3 vs. 16.1 ± 3.5, p = 0.023; 13.5 ± 4.3 vs. 15.0 ± 4.3, p = 0.049, respectively). In individuals with OCPD, higher levels of rigidity correlated with physical fatigue (ρ = 0.463, p = 0.002) and reduced activity (ρ = 0.363, p = 0.018), while preoccupation with details was associated with reduced motivation (ρ = 0.437, p = 0.004). In conclusion, in individuals with CMD and comorbid OCPD, several OCPD traits were significantly related to subjective measures of fatigue. As traits are considered stable features, there results suggest they might play a causative role in generating subjective fatigue in CMD.

Obsessive-Compulsive Personality Disorder and Death by Suicide

IntroductionThe risk of suicide may be elevated in the presence of personality pathology. Adults with Obsessive Compulsive Personality Disorder (OCPD) may be vulnerable to depression and suicidal thoughts.ObjectivesTo identify factors associated with suicide in cases of OCPD.MethodsPsychological autopsy procedures were used to gather detailed information about adults who died by suicide and natural causes. A total of 75 deceased adults were evaluated using psychological autopsy procedures. Family members were interviewed about a recently deceased adult, using structured diagnostic interviews (SCID and SIDP-IV). Diagnostic summaries, coroner’s reports and police records were reviewed by a psychiatrist, a psychologist, a social worker, and a neuroscientist until agreement was reached about final diagnosis. The final sample included 40 adults who met criteria for OCPD (18 had died by suicide; 20 had died by natural causes). An additional 40 cases were examined in which evidence of PD was absent (19 had died by suicide; 18 had died by natural causes).ResultsThe diagnosis of a Major Depressive Disorder was significantly more common in suicide completers with OCPD compared to suicide completers without OCPD (X2 = 6.74, p < .01) or cases of natural death with OCPD (X2 = 12.70, p < .001). Suicide completers with OCPD displayed many symptoms of depression, more often than suicide completers without OCPD or cases of natural death with OCPD (see Table 1). As compared to the cases of natural death, both groups of suicide completers were more likely to have previously attempted suicide prior to their final act (X2 = 8.52, p < .05). Table 1.Comparison of four groups using psychological autopsy procedures to identify the presence of diagnostic criteria for a Major Depressive Episode at the time of death.OCPD SuicideOCPD Natural DeathNo PD SuicideNo PD Natural DeathX2Sad mood82.4%36.8%78.9%50.0%11.38 **Sleep disturbance82.4%38.9%73.7%46.7%9.53 *Feelings of worthlessness60.0%38.9%84.2%17.6%17.49 ***Reduced concentration58.8%27.8%57.9%14.3%9.89 *Recurrent suicidal ideation88.2%26.3%78.9%0.0%35.57 ***Loss of pleasure82.4%38.9%73.7%40.0%10.80 **Psychomotor changes50.0%33.3%61.1%26.7%5.04Reduced energy64.7%44.4%63.2%33.3%4.12Change of appetite70.6%26.3%42.1%31.3%8.37 *Note:*= p < .05;**= p < .01;***= p < .001ConclusionsAdults with OCPD appear vulnerable to a Major Depressive episode, and the combination of MDD with OCPD creates a significant risk for death by suicide. It is important to appreciate the influence of personality disorder or depression and suicide risk.Disclosure of InterestNone Declared

The impact of obsessive-compulsive personality disorder in perfectionism

Objective The construct of perfectionism has long been related to Obsessive-Compulsive Personality Disorder (OCPD), though research has not considered how OCPD could distinguish individuals with elevated perfectionism. The aim of this study was to evaluate clinical differences between those with and without OCPD in a sample of individuals with elevated perfectionism. Methods Seventy-four university students with elevated perfectionism completed a diagnostic assessment and several self-report measures of clinical characteristics and were randomly assigned to complete an exposure-based treatment for perfectionism or waitlist. Thirty-four (45.95%) participants met DSM-IV diagnostic criteria for OCPD. Results Compared to those without OCPD, individuals with OCPD had higher levels of general and specific domains of perfectionism and higher levels of social anxiety. OCPD diagnosis was also associated with higher rates of current anxiety disorder. Importantly, those with and without OCPD showed comparable benefits from treatment. Conclusions This study provides novel evidence of the role of OCPD in perfectionism and demonstrates the efficacy of a perfectionism-oriented treatment in individuals with OCPD. Key points We examined the role of obsessive-compulsive personality disorder (OCPD) in a high perfectionism sample. OCPD was associated with higher perfectionism and personal standards. OCPD was also associated with higher social anxiety and higher rates of current anxiety disorder. Those with and without OCPD had comparable responses to an exposure-based treatment for perfectionism.

Validation of the Five-Factor Obsessive-Compulsive Inventory in a Mental Health Sample.

The Five-Factor Obsessive-Compulsive Inventory (FFOCI) is a recently developed measure of obsessive-compulsive personality disorder (OCPD) based on an established dimensional model of general personality, the five-factor model. The present study aimed to evaluate the construct validity of the FFOCI by examining its associations with both traditional and dimensional diagnostic models of OCPD. This study used an archival data set of mental health patients that employed a multimethod design. A total of 214 individuals (and their nominated informants) completed various personality inventories indexing the Diagnostic and Statistical Manual for Mental Disorders-Fifth edition traditional and Alternative Model of Personality Disorders (AMPD) diagnostic criteria for OCPD, as well as other individual AMPD personality traits deemed conceptually relevant to the FFOCI. The results were generally quite supportive of construct validity. They showed that FFOCI scale scores converged with traditional measures of OCPD and AMPD-OCPD traits and impairment in a conceptually expected manner, with a few exceptions. Overall, it was clear from these findings that the FFOCI takes a broader and more comprehensive approach to the assessment of obsessive-compulsive than traditional Diagnostic and Statistical Manual and AMPD operationalizations.

OBSESSIVE COMPULSIVE PERSONALITY AND FATIGUE IN PATIENTS WITH ANXIETY AND MOOD DISORDERS

Introduction Prior analysis has demonstrated executive dysfunction as a cardinal feature of fatigue in a post myocardial infarction population [1]. Executive problems have also been demonstrated in a group of subjects with obsessive compulsive personality disorder (OCPD) [2]. Traits of OCPD are commonly associated with depression, which has fatigue as an intrinsic element; however, so far no study has investigated the possibility of a specific association between fatigue and OCPD. Aim To investigate whether measures of fatigue and OCPD were associated, in a sample of patients with anxiety and mood disorders (AMD) demonstrating high levels of fatigue. Material and Methods A cross-sectional study of patients with AMD attending a Stress Disorders Clinic. Socio-demographic and clinical information including diagnosis (as defined by The Mini International Neuropsychiatric Interview), medication use, body mass index, and history of smoking were collected. The severity of OCPD traits was evaluated using the observer-rated Compulsive Personality Assessment Scale (CPAS) [2]. The Multidimensional Fatigue Inventory (MFI-20) was used to assess general, physical and mental fatigue, reduced activity and motivation. The Beck Depression Inventory-II (BDI-II) and the Hamilton Depression Rating Scale (HAM-D) were employed to measure subjective and objective symptoms of depression, while the Hamilton Anxiety Rating Scale (HAM-A) measured anxiety symptoms. Two-tailed Student’s t-test or Fisher’s χ2 test were applied to compare socio-demographic, clinical, fatigue, anxiety and depression characteristics in AMD patients with and without OCPD. Binary logistic regression analyses were performed to test associations between OCPD and fatigue, while controlling for possible confounders. Results Sixty-seven patients participated, 49 (73.1 %) females with a mean age of 39±13. In this group, 14 (20.9%) patients had one mood disorder, 17 (25.4%) had one anxiety disorder, and the remaining 36 (53.7%) patients suffered simultaneously from AMD. Nine patients (13.4%) fulfilled operational criteria for OCPD. The OCPD group had higher subjective depression scores on the BDI-II relative to patients without OCPD (35.1±14.1 vs. 23.5±11.1; p = 0.007). However, scores on the HAM-D and HAM-A scales did not show any difference between groups (p’s > 0.05). Measures of physical and mental fatigue were higher among OCPD patients than non-OCPD (respectively, 81.9±22.8 vs. 62.5±25.8, p = 0.037; 88.9±13.5 vs. 65.7±27.6, p = 0.017). Controlling for potential confounders i.e. depression scores (BDI-II), age, gender, medication use and reduced motivation, the association between mental fatigue and OCPD remained significant and was associated with a 1.072-fold increase (95% confidence, 1.002 to 1.147, p = 0.045) in risk for OCPD. There was no longer a significant effect of physical fatigue on OCPD. Conclusions Mental fatigue in patients with AMD is associated with OCPD traits even when depression and reduced motivation symptoms are taken into account. Thus, mental fatigue might represent a previously under-explored marker of OCPD. Further investigation of mental fatigue in diverse groups of patients is needed to confirm this finding.

Examining the DSM-5 Section III Criteria for Obsessive-Compulsive Personality Disorder in a Community Sample.

The current study examined the extent to which the trait-based operationalization of obsessive-compulsive personality disorder (OCPD) in Section III of the DSM-5 describes the same construct as the one described in Section II. A community sample of 313 adults completed a series of personality inventories indexing the DSM-5 Sections II and III diagnostic criteria for OCPD, in addition to a measure of functional impairment modelled after the criteria in Section III. Results indicated that latent constructs representing Section II and Section III OCPD overlapped substantially (r = .75, p < .001). Hierarchical latent regression models revealed that at least three of the four DSM-5 Section III facets (Rigid Perfectionism, Perseveration, and Intimacy Avoidance) uniquely accounted for a large proportion of variance (53%) in a latent Section II OCPD variable. Further, Anxiousness and (low) Impulsivity, as well as self and interpersonal impairment, augmented the prediction of latent OCPD scores.

Coverage of the DSM-IV-TR/DSM-5 Section II Personality Disorders With the DSM-5 Dimensional Trait Model.

Section III of DSM-5, for emerging measures and models, includes a five-domain, 25-trait model, assessed by the Personality Inventory for DSM-5. A primary concern with respect to the trait model is its coverage of the DSM-IV-TR personality disorder syndromes (all of which were retained in DSM-5). The current study considered not only total scale scores of three independent measures of DSM-IV-TR personality disorders but also the coverage of each diagnostic criterion included within six personality disorders: antisocial, borderline, avoidant, dependent, narcissistic, and obsessive-compulsive. Participants were 425 community adults, all of whom had received mental health treatment (36% currently; 75% within the past year). Results provided support for the coverage of the diagnostic criteria for the antisocial, borderline, avoidant, dependent, and narcissistic personality disorders. Coverage could perhaps be improved for a few of the criteria for obsessive-compulsive personality disorder.

Enhanced visual performance in obsessive compulsive personality disorder.

Visual performance is considered as commanding modality in human perception. We tested whether Obsessive-compulsive personality disorder (OCPD) people do differently in visual performance tasks than people without OCPD. One hundred ten students of Ferdowsi University of Mashhad and non-student participants were tested by Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), among whom 18 (mean age = 29.55; SD = 5.26; 84% female) met the criteria for OCPD classification; controls were 20 persons (mean age = 27.85; SD = 5.26; female = 84%), who did not met the OCPD criteria. Both groups were tested on a modified Flicker task for two dimensions of visual performance (i.e., visual acuity: detecting the location of change, complexity, and size; and visual contrast sensitivity). The OCPD group had responded more accurately on pairs related to size, complexity, and contrast, but spent more time to detect a change on pairs related to complexity and contrast. The OCPD individuals seem to have more accurate visual performance than non-OCPD controls. The findings support the relationship between personality characteristics and visual performance within the framework of top-down processing model.

A longitudinal, population-based twin study of avoidant and obsessive-compulsive personality disorder traits from early to middle adulthood.

The phenotypic stability of avoidant personality disorder (AVPD) and obsessive-compulsive personality disorder (OCPD) has previously been found to be moderate. However, little is known about the longitudinal structure of genetic and environmental factors for these disorders separately and jointly, and to what extent genetic and environmental factors contribute to their stability. AVPD and OCPD criteria were assessed using the Structured Interview for DSM-IV Personality in 2793 young adult twins (1385 pairs, 23 singletons) from the Norwegian Institute of Public Health Twin Panel at wave 1 and 2282 (986 pairs, 310 singletons) of these on average 10 years later at wave 2. Longitudinal biometric models were fitted to AVPD and OCPD traits. For twins who participated at both time-points, the number of endorsed sub-threshold criteria for both personality disorders (PDs) decreased 31% from wave 1 to wave 2. Phenotypic correlations between waves were 0.54 and 0.37 for AVPD and OCPD, respectively. The heritability estimates of the stable PD liabilities were 0.67 for AVPD and 0.53 for OCPD. The genetic correlations were 1.00 for AVPD and 0.72 for OCPD, while the unique environmental influences correlated 0.26 and 0.23, respectively. The correlation between the stable AVPD and OCPD liabilities was 0.39 of which 63% was attributable to genetic influences. Shared environmental factors did not significantly contribute to PD variance at either waves 1 or 2. Phenotypic stability was moderate for AVPD and OCPD traits, and genetic factors contributed more than unique environmental factors to the stability both within and across phenotypes.

Obsessive-compulsive personality disorder: a current review.

This review provides a current overview on the diagnostics, epidemiology, co-occurrences, aetiology and treatment of obsessive-compulsive personality disorder (OCPD). The diagnostic criteria for OCPD according to the recently published Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) include an official set of criteria for clinical practice and a new, alternative set of criteria for research purposes. OCPD is a personality disorder prevalent in the general population (3-8 %) that is more common in older and less educated individuals. Findings on sex distribution and course of OCPD are inconsistent. OCPD is comorbid with several other medical and psychological conditions. As for causes of OCPD, most empirical evidence provides support for disturbed attachment as well as the heritability of OCPD. So far, cognitive (behavioural) therapy is the best validated treatment of OCPD. Self-esteem variability, stronger early alliances as well as the distress level seem to predict cognitive (behavioural) therapy outcome. Future research is needed to further advance knowledge in OCPD and to resolve inconsistencies.

2783 – Distress level and treatment outcome in obsessive-compulsive personality disorder (OCPD)

Previous research has linked OCPD with increased distress levels that may lead to differences in treatment response. The present study aimed to investigate the influence of pre-treatment distress on patient's response to groupbased cognitive-behavioral therapy (CBT) for OCPD. 116 out-patients who met DSM-IV-TR diagnostic criteria for OCPD completed a pre-treatment assessment including BDI, STAI, STAXI-2, GRAI and Rosemberg Self-Esteem Scale. Pre-treatment distress was operationalized as depression and anxiety levels. Intervention was comprised of ten group sessions including psychoeducation, specific CBT techniques and relapse prevention. In order to assess treatment response after intervention, the sample was divided in two groups: 1) discharged patients - responders and 2) patients who needed to continue treatment - non responders. Assessment scores were compared using t test in order to analyze differences between groups. The extent to which potential predictor variables were related to treatment response was assessed using logistic regression. Results showed statistically significant differences (p < 0.05) in depressed mood and state anxiety scores between responder and non-responder groups. Initial variable selection for logistic regression model included age, sex, depression, anxiety, anger, assertiveness and selfesteem scores. The final model included state anxiety as a significant predictor of treatment response. Our findings indicate that responder patients had lower pre-treatment distress levels than non-responder patients and that state anxiety score is a significant predictor of group-based CBT response in OCPD. According to this, pretreatment distress levels might be considered for treatment planning, despite more research in this direction would be necessary.

First steps in FAP: Experiences of beginning Functional Analytic Psychotherapy therapist with an obsessive-compulsive personality disorder client.

Practicing Functional Analytic Psychotherapy (FAP) for the first time can seem daunting to therapists. Establishing a deep and intense therapeutic relationship, identifying FAP’s therapeutic targets of clinically relevant behaviors, and using contingent reinforcement to help clients emit more functional behavior in the therapeutic relationship all present significant challenges. This article describes a first-time FAP therapy conducted with a client meeting criteria for obsessive-compulsive personality disorder and also presenting features of borderline personality disorder. The case illustrates how a first-time FAP therapist can meet these challenges and make use the supervision relationship as an aid.

Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder

Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome.

Comorbid obsessive–compulsive personality disorder in obsessive–compulsive disorder (OCD): A marker of severity

Comorbid obsessive-compulsive personality disorder (OCPD) is well-described in obsessive-compulsive disorder (OCD). It remains unclear, however, whether OCPD in OCD represents a distinct subtype of OCD or whether it is simply a marker of severity in OCD. The aim of this study was to compare a large sample of OCD subjects (n=403) with and without OCPD on a range of demographic, clinical and genetic characteristics to evaluate whether comorbid OCPD in OCD represents a distinct subtype of OCD, or is a marker of severity. Our findings suggest that OCD with and without OCPD are similar in terms of gender distribution and age at onset of OC symptoms. Compared to OCD-OCPD (n=267, 66%), those with OCD+OCPD (n=136, 34%) are more likely to present with the OC symptom dimensions which reflect the diagnostic criteria for OCPD (e.g., hoarding), and have significantly greater OCD severity, comorbidity, functional impairment, and poorer insight. Furthermore there are no differences in distribution of gene variants, or response to treatment in the two groups. The majority of our findings suggest that in OCD, patients with OCPD do not have a highly distinctive phenomenological or genetic profile, but rather that OCPD represents a marker of severity.

Hoarding disorder: a new diagnosis for DSM-V?

This article provides a focused review of the literature on compulsive hoarding and presents a number of options and preliminary recommendations to be considered for DSM-V. In DSM-IV-TR, hoarding is listed as one of the diagnostic criteria for obsessive-compulsive personality disorder (OCPD). According to DSM-IV-TR, when hoarding is extreme, clinicians should consider a diagnosis of obsessive-compulsive disorder (OCD) and may diagnose both OCPD and OCD if the criteria for both are met. However, compulsive hoarding seems to frequently be independent from other neurological and psychiatric disorders, including OCD and OCPD. In this review, we first address whether hoarding should be considered a symptom of OCD and/or a criterion of OCPD. Second, we address whether compulsive hoarding should be classified as a separate disorder in DSM-V, weighing the advantages and disadvantages of doing so. Finally, we discuss where compulsive hoarding should be classified in DSM-V if included as a separate disorder. We conclude that there is sufficient evidence to recommend the creation of a new disorder, provisionally called hoarding disorder. Given the historical link between hoarding and OCD/OCPD, and the conservative approach adopted by DSM-V, it may make sense to provisionally list it as an obsessive-compulsive spectrum disorder. An alternative to our recommendation would be to include it in an Appendix of Criteria Sets Provided for Further Study. The creation of a new diagnosis in DSM-V would likely increase public awareness, improve identification of cases, and stimulate both research and the development of specific treatments for hoarding disorder.

Comorbidity of obsessive–compulsive disorder with obsessive–compulsive personality disorder: Does it imply a specific subtype of obsessive–compulsive disorder?

The present study examined whether the comorbidity of obsessive–compulsive personality disorder (OCPD) and obsessive–compulsive disorder (OCD) constitute a specific subtype of OCD. The study sample consisted of 146 consecutive outpatients with a DSM-IV diagnosis of OCD. Diagnoses were established using MINI, IPDE, YBOCS and YBOCS-SC. OCD patients with comorbid OCPD were compared with OCD patients without OCPD on various sociodemographic and clinical variables. Almost one third of the OCD subjects met criteria for comorbid OCPD. OCD + OCPD patients had a significantly earlier age at onset of initial OC symptoms, earlier age at onset of OCD and more obsessions and compulsions than pure obsessions compared to the patients with OCDOCPD. OCD + OCPD patients also had a higher rate of comorbidity with avoidant personality disorder and showed more impairment in global functioning. There were not differences between the two sub-groups on severity of OCD symptoms and also on type of OCD onset. Our results indicate that the comorbidity of OCD with OCPD is associated with a number of specific clinical characteristics of OCD. These findings in conjunction with of current clinical, family and genetic studies provide some initial evidence that OCD comorbid with OCPD constitute a specific subtype of OCD.

Obsessive-compulsive personality disorder traits and personality dimensions in parents of children with obsessive-compulsive disorder

Purpose To compare patterns of temperament and character and the prevalence of Obsessive-Compulsive Personality Disorder (OCPD) and OCPD traits in parents of children with OCD and parents of healthy controls. Methods TCI and SCID-II were administered to 63 parents of 32 children with OCD and 63 parents of age- and sex-matched controls with no psychiatric diagnosis. Interviewers were not blind to proband status. Personality dimension scores and frequencies of OCPD criteria in both groups were compared after excluding parents with a diagnosis of OCD. Relationships between TCI dimensions and OCPD symptoms in parents and the clinical characteristics of OCD children were also studied. Results Parents of OCD children presented significantly higher scores in harm avoidance and lower scores in self-directedness, cooperativeness and reward dependence than parents of healthy children. A higher incidence of OCPD was found in parents of probands ( p < 0.02). Hoarding, perfectionism and preoccupation with details were significantly more frequent in parents of OCD children. Counting, ordering and cleaning compulsions in OCD children predicted elevated odds of perfectionism and rigidity in their parents. Conclusions The existence of the dimensional personality profile associated with OCD in parents of children with OCD and the higher number of OCPD criteria in these parents in comparison to parents of healthy children highlight the importance of the role of personality factors in familial OCD.

Structure of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Criteria for Obsessive—Compulsive Personality Disorder in Patients with Binge Eating Disorder

To examine 1-, 2-, and 3-factor model structures through confirmatory analytic procedures for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) obsessive-compulsive personality disorder (OCPD) criteria in patients with binge eating disorder (BED). Participants were consecutive outpatients (n = 263) with binge eating disorder and were assessed with semi-structured interviews. The 8 OCPD criteria were submitted to confirmatory factor analyses in Mplus Version 4.2 (Los Angeles, CA) in which previously identified factor models of OCPD were compared for fit, theoretical relevance, and parsimony. Nested models were compared for significant improvements in model fit. Evaluation of indices of fit in combination with theoretical considerations suggest a multifactorial model is a significant improvement in fit over the current DSM-IV single- factor model of OCPD. Though the data support both 2- and 3-factor models, the 3-factor model is hindered by an underspecified third factor. A multifactorial model of OCPD incorporating the factors perfectionism and rigidity represents the best compromise of fit and theory in modelling the structure of OCPD in patients with BED. A third factor representing miserliness may be relevant in BED populations but needs further development. The perfectionism and rigidity factors may represent distinct intrapersonal and interpersonal attempts at control and may have implications for the assessment of OCPD.

The Quality of the DSM-IV Obsessive-Compulsive Personality Disorder Construct as a Prototype Category

The study evaluated the quality of the DSM-IV obsessive-compulsive personality disorder (OCPD) construct as a prototype category. A sample of 2237 patients from the Norwegian Network of Psychotherapeutic Day Hospitals was examined by a variety of psychometric analyses. A high number of OCPD patients (77%) had co-occurrent PDs, but only the co-occurrence with paranoid was significantly higher than expected. Exploratory factor analysis of the PD criteria indicated that OCPD consists of 2 dimensions. The first dimension, perfectionism, was constituted by OCPD criteria only and was significantly related to obsessive-compulsive disorder. The second dimension, aggressiveness, included 2 OCPD criteria, reluctance to delegate and stubbornness, but was also defined by criteria from paranoid, antisocial, and borderline PD. Confirmatory factor analysis of the OCPD criteria indicated a poor fit of both a unitary model and a 3-dimensional model. Overall, the OCPD criteria had poor psychometric properties. Although it seems that the quality of the DSM-IV OCPD as a prototype construct is insufficient, it may be improved by deleting the criteria hoarding behavior and miserliness. Alternative criteria could be related to problems in close relationships involving the need for predictability. Such revisions may add a third dimension to the 2 dimensions of perfectionism and aggressiveness.

OCD with comorbid OCPD: A subtype of OCD?

Objective The current study examined the validity of using comorbid obsessive–compulsive personality disorder (OCPD) to identify a subtype of individuals with obsessive–compulsive disorder (OCD). Method Data for the current study were drawn from an ongoing, longitudinal study of the course of OCD and include intake assessments for 238 subjects with primary and current DSM-IV OCD who were treatment seeking. Results More than one fourth of the subjects ( N = 65, 27%) met criteria for comorbid OCPD. As compared to OCD − OCPD subjects, the OCD + OCPD subjects had a significantly younger age at onset of first OC symptoms ( p = 0.013), and a higher rate of symmetry and hoarding obsessions, and cleaning, ordering, repeating, and hoarding compulsions (all p’s < 0.01). Individuals with OCD + OCPD had higher rates of comorbid anxiety disorders ( p = 0.007) and avoidant personality disorder ( p = 0.006). The OCD + OCPD subjects also had significantly lower ratings of global functioning ( p = 0.001) and more impaired social functioning ( p = 0.004), despite a lack of significant differences on overall severity of OCD symptoms. Conclusions Our findings indicate that individuals with both OCD and OCPD have distinct clinical characteristics in terms of age at onset of initial OC symptoms, the types of obsessions and compulsions they experience, and psychiatric comorbidity. Our findings, coupled with data from family studies showing a higher than expected frequency of OCPD in first degree relatives of OCD probands, suggest that OCD associated with OCPD may represent a specific subtype of OCD. Additional research is warranted to further establish the validity of this subtype.